ADVANCEMENT OF THE PRACTICE
DIRECT FROM ATSDR
The Environmental Justice Index: Measuring Cumulative Impacts of Environmental Burdens on Health
Lauren Freelander, MS Benjamin McKenzie, MS Erica Lehnert, MS, MPH Barry Flanagan, PhD Michel Conn, MS Gabriele Richardson, PhD Geospatial Research, Analysis, and Services Program Office of Innovation and Analytics Agency for Toxic Substances and Disease Registry/National Center for Environmental Health Centers for Disease Control and Prevention
Editor’s Note: As part of our continued eort to highlight innovative approaches to improve the health and environment of communities, the Journal is pleased to publish regular columns from the Agency for Toxic Substances and Disease Registry (ATSDR) at the Centers for Disease Control and Prevention (CDC). ATSDR serves the public by using the best science, taking responsive public health actions, and providing trusted health information to prevent harmful exposures and diseases related to toxic substances. The purpose of this column is to inform readers of ATSDR’s activities and initiatives to better understand the relationship between exposure to hazardous substances in the environment, its impact on human health, and how to protect public health. The findings and conclusions of this column are those of the author(s) and do not necessarily reflect the views of CDC or ATSDR. Lauren Freelander, Benjamin McKenzie, and Erica Lehnert are geospatial epidemiologists at CDC/ATSDR. Dr. Barry Flanagan is a social geographer at CDC/ATSDR. Michel Conn and Dr. Gabriele Richardson are senior geospatial analysts at CDC/ATSDR. Dr. Angela Werner is a lead health scientist at CDC.
ties facing cumulative impacts on their health from environmental and social burdens. The EJI is calculated at the census tract level, a geographic unit that is useful for analyzing community-level data for policy and plan- ning (Krieger, 2006). The census tract level is also a standard unit used for tools that map national cumulative impacts. Indicators of the Environmental Justice Index Potential indicators for the EJI were identified based on the results of a thorough literature review, including a scoping review of current environmental justice literature and tools. Potential indicators were then evaluated to ensure that the data: 1.Come from a trusted, reliable, and stable national data source; 2.Accurately measure what they intend to; 3.Are at or can be easily aggregated to the census tract level; and 4.Are regularly updated for inclusion in future iterations of the EJI (ATSDR, 2023). Following the application of these crite- ria, we identified 36 indicators, grouped into 10 domains and 3 overarching modules: the Social Vulnerability Module, Environmental Burden Module, and Health Vulnerability Module (Figure 1). Angela K. Werner, MPH, PhD National Environmental Public Health Tracking Program Division of Environmental Health Science and Practice National Center for Environmental Health Centers for Disease Control and Prevention
I ntroduction The environmental justice movement has increased awareness that contamination of land, air, and water has disparate impacts on communities in the U.S. and that ending envi- ronmental injustice can only be accomplished with the diminution of race, gender, and class inequities (Bullard, 2001; Perez et al., 2015). To this end, the focus of scientific research on justice-centered environmental activism has increased in recent years, as has the develop- ment of tools aimed at helping reduce environ- mental injustices (Lee, 2020). In response to calls for state and federal tools that address the cumulative impacts of environmental injustice on health (Callahan et al., 2021; Lee, 2020), the Geospatial Research,
Analysis, and Services Program (GRASP) at the Centers for Disease Control and Preven- tion/Agency for Toxic Substances and Disease Registry (CDC/ATSDR) partnered with the National Environmental Public Health Track- ing Program within CDC and the Oce of Environmental Justice within the U.S. Depart- ment of Health and Human Services to develop the Environmental Justice Index (EJI). The index was publicly released in August 2022. Development of the Environmental Justice Index The EJI is the first place-based, nationwide index designed to help public health o- cials, community-based organizations, and researchers identify and support communi-
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Volume 86 • Number 2
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